Evidence map›Paper›PMID 32386972›Full record

SynthesisJournal of pediatric surgery2020

Minimally invasive surgery for pediatric renal tumors: A systematic review by the APSA Cancer Committee.

Marcus M Malek, Christopher A Behr, Jennifer H Aldrink, Roshni Dasgupta, Todd E Heaton, Alison Gehred, Timothy B Lautz, Reto M Baertschiger, Emily R Christison-Lagay, Elisabeth T Tracy and 4 more

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Journal of pediatric surgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
1.6field-weighted citation impact, top 17% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it, 28 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Article
  4. Article
  5. Article
  6. Review
  7. Article
  8. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors at 13 institutions in 2 countries.

Marcus M MalekDepartment of Surgery, Division of Pediatric Surgery, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, PA. Electronic address: marcus.malek@chp.edu.
Christopher A BehrDepartment of Surgery, Division of Pediatric Surgery, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, PA.
Jennifer H AldrinkDepartment of Surgery, Division of Pediatric Surgery, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH.
Roshni DasguptaDivision of Pediatric General and Thoracic Surgery, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH.
Todd E HeatonDepartment of Surgery, Division of Pediatric Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.
Alison GehredGrant Morrow, III MD Medical Library, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH.
Timothy B LautzAnn & Robert H Lurie Children's Hospital of Chicago, Northwestern University, Chicago, IL.
Reto M BaertschigerHospital for Sick Children, University of Toronto, Toronto, ON, Canada.
Emily R Christison-LagayDivision of Pediatric General and Thoracic Surgery, Yale-New Haven Children's Hospital, Yale School of Medicine, New Haven, CT.
Elisabeth T TracyDepartment of Surgery, Division of Pediatric Surgery, Duke University Medical Center.
Daniel S RheeDepartment of Surgery, Division of Pediatric Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.
David RodebergDepartment of Surgery, Division of Pediatric Surgery, East Carolina University, Greenville, NC.
Mary T AustinDepartment of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX.
Peter F EhrlichDepartment of Pediatric Surgery, University of Michigan, C.S. Mott Children's Hospital, Ann Arbor, MI.
Nationwide Children's Hospital · USChildren's Hospital of Pittsburgh · USCincinnati Children's Hospital Medical Center · USDuke Medical Center · USEast Carolina University · USHospital for Sick Children · CAJohns Hopkins University · USLurie Children's Hospital · USMemorial Sloan Kettering Cancer Center · USThe University of Texas MD Anderson Cancer Center · USUniversity of Michigan–Ann Arbor · USUniversity of Pittsburgh · USYale New Haven Hospital · US

Funding

X-RAY CRYSTALLOGRAPHYP30CA008748 · NCI · SLOAN-KETTERING INSTITUTE FOR CANCER RES · PI Hongbiao Carl Lekaye · 1985 to 2026
$347.4M
6 · The paper itself

Abstract

Minimally invasive nephrectomy is performed routinely for adult renal tumors and for many benign pediatric conditions. Although open radical nephroureterectomy remains the standard of care for Wilms tumor and most pediatric renal malignancies, there are an increasing number of reports of minimally invasive surgery (MIS) for those operations as well. The APSA Cancer Committee performed a systematic review to better understand the risks and benefits of MIS in pediatric patients with renal tumors.

methodsThe search focused on MIS for renal tumors in children and followed the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) checklist. The initial database search identified 491 published articles, and after progressive review of abstracts and full-length articles, 19 were included in this review.

resultsThere were two direct comparison studies where open surgery and MIS were compared. The remaining studies reported only on minimally invasive nephrectomy. Across all studies, there were a total of 151 patients, 126 of which had Wilms tumor and 10 patients had RCC. 104 patients had MIS, with 47 patients having open surgery. In the two studies in which open surgery and MIS were directly compared, more lymph nodes were harvested during open surgery (median = 2 (MIS) vs 5 (open); mean = 2.47 (MIS) vs 3.8 (open)). Many noncomparison studies reported the harvest of 2 of fewer lymph nodes for Wilms tumor. Several MIS patients were also noted to have intraoperative spill or positive margins. Survival between groups was similar.

conclusionsThere is a lack of evidence to support MIS for pediatric renal tumors. This review demonstrates that lymph node harvest has been inadequate for MIS pediatric nephrectomy and there appears to be an increased risk for intraoperative spill. Survival data are similar between groups, but follow-up times were inconsistent and patient selection was clearly biased, with only small tumors being selected for MIS. TYPE OF STUDY: Review article. LEVEL OF EVIDENCE: III.

Indexed as

Kidney NeoplasmsMinimally Invasive Surgical ProceduresWilms TumorChildHumansNephrectomyRetrospective StudiesLaparoscopyMinimally invasive surgeryNephrectomyNephroureterectomySurgical oncologyWilms tumor

Identifiers

PMID32386972
OpenAlexW3014696782

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.